On September 5, 2018, Secretary of Health and Human Services (HHS) Alex Azar sent a one-page letter with a nine-page attachment of spreadsheets to the chairs and ranking Democrats of the relevant appropriations committees in the U.S. House of Representatives and U.S. Senate. The letter informed each member that Azar would be transferring $266 million from programs within the FY18 HHS budget to the Unaccompanied Minors Program, also within the department. This program is responsible for caring for the alien children who have been at the heart of a media and political firestorm since earlier this year.
The attached spreadsheets explain from where, within the complete FY18 HHS budget, the $266 million will be taken. Just over $87 million will come from various institutes and centers within the U.S. National Institutes of Health (NIH). Thirteen million dollars will be taken from the National Cancer Institute. The FY18 budget at the National Institute of Allergy and Infectious Diseases will be lowered by $12 million, and the National Heart, Lung, and Blood Institute budget will be reduced by $7.9 million. Other institutes at the NIH also have their budget cuts at various levels. Almost $17 million will be taken from programs within the Centers for Disease Control and Prevention.
In his letter to the congressional appropriators, Secretary Azar explains the need for additional funds from other programs. Azar says, “The number of unaccompanied alien children has increased steadily, and existing shelter capacity is nearly full. HHS is closely monitoring shelter capacity needs and is in communication with our interagency partners. Based on this growth pattern, and an increased length of time needed to safely release unaccompanied alien children to sponsors, HHS is preparing for the trend of high capacity to continue.”
Recognizing that unanticipated events can arise during a fiscal year, Congress provides heads of agencies with authority to move money from one program to another. The scope of the authority varies between federal agencies and that of the Secretary of Health and Human Services is more limited than most. Nevertheless, the movement of funds described by Secretary Azar is within the limits defined in the FY19 HHS appropriations bill, which states that the Secretary may not transfer more than 1% from one program, cannot increase the recipient program’s budget by more than 3%, and cannot create a new program or fund a program not funded by Congress.